Suicide is a complicated and complex issue. The last time I considered taking my life I was 33 years old, and while, on paper, everything looked good — I had a loving husband, adoring daughter, beautiful house and great job — inside, I was falling apart. I was a ghost in a shell. A child without a family or home.
Of course, I know that may not make sense. How can one possibly feel hopeless and lost while simultaneously feeling so full and loved? But living with mental illness most of my life has taught me several things. I know my brain lies. Emotions lie, and feelings aren’t facts. In the grips of a depressive episode, I believe things that aren’t true.
But in spite of my awareness (and both personal and professional support), I struggle to ask for help when I am hurting. I feel stupid and pathetic. In my head, I hear echoes of failure: “You are hopeless. You are helpless. You are weak. No one cares.” And I believe I am a burden.
My negativity has the power to not only bring down my friends but an entire room.
Plus, I don’t know what to say. I am sad, but there is no reason. I feel empty and numb, but I cannot tell you why.
But I also know my friends and family would rather hear about my depression than my death. Which is why we should all become more comfortable talking about the uncomfortable. Mental health and suicide are matters which need to be addressed head-on.
There is a common misconception that having a talk about suicide can make matters worse. Some believe mentioning the term can be upsetting or put the idea in someone’s head. But not only has the latter been disproven — a 2005 study found no correlation between these questions and suicidal thoughts or behaviors — we also know silence is dangerous. Since suicide is the 10th leading cause of death in the U.S., silence can be deadly.
So what can you do? How can you help? These are the best ways to support someone who may be suicidal.
1. Ask your loved one if they are considering suicide.
If your friend seems absent, distant, makes flippant remarks about death, is behaving recklessly, carelessly or generally uncharacteristic, and/or expresses a sense of helplessness or hopelessness — as many considering suicide often do — a heart-to-heart may be in order. After all, a loving conversation is more important than no conversation. So speak up. Reach out. Offer to help and ask them — point blank — if they are contemplating suicide. Using the word helps to remove shame and stigma and asking another about their thoughts and feelings gives them the opportunity (and, in some cases, a much-needed sense of permission) to talk about their problems.
It also lets them know they are not alone, and that somebody cares.
That said, avoid asking in a leading or judgmental way, i.e. “You’re not thinking of doing anything stupid, are you?” This can (and will) do more harm than good.
2. Listen. Like really listen.
This may seem simple and obvious, but most of us listen passively. We ask how someone’s day is (or was) without truly hearing them. The reasons for this are plentiful: We are overworked, overwhelmed and busy. However, if you want to truly help someone active, judgment-free listening is important. Someone who is anxious, depressed, or suicidal needs your undivided attention. You may hear things you don’t want to and/or discuss topics you are not comfortable with (disordered behaviors, suicidal thoughts, intentions or plans), so please do not make this offer if this is something you are ill-prepared for. Disengaging can do irrevocable damage.
3. Acknowledge their pain and validate their feelings.
They say misery loves company, but the truth is we all just want to be heard and understood. So empathize (as best you can) and say things like, “That’s hard. Things must really be awful if you are feeling that way; you must be in a lot of pain.”
4. Tell them you love and care about them.
If you believe it, say it. Reassurance can go a long way.
5. Probe deeper.
Once you’ve initiated the conversation and reminded your friend they are safe, loved and supported, you need to assess the situation. According to Mental Health First Aid, this can be done by asking:
– Are you having thoughts of suicide?
– Do you have a plan to kill yourself?
– Have you decided when you’d do it?
– Do you have everything you need to carry out your plan?
6. Develop an action plan.
If you find they have a plan and the tools to carry it out, call 911. According to Mental Health First Aid, “it’s better to be safe than for someone to lose their life.”
If you determine the person is having suicidal thoughts but there’s no immediate danger, talk to them. Keep them safe, and encourage them to seek treatment or help. They (or you) can call the National Suicide Prevention Lifeline at 1-800-273-8255, they can text TALK to 741741 to speak with a trained crisis counselor from the Crisis Text Line, and/or they can contact their doctor or therapist.
It’s scary to talk about suicide — and you should never enter into this conversation lightly — but the only way to remove the shame and stigma surrounding suicide is to discuss it. Openness, empathy, honesty and support can save lives.